Maternal weight and the obesogenic environment in nova scotia
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Maternal weight and the obesogenic environment in Nova Scotia. Sara Kirk, Louise Parker, Trevor Dummer, Linda Dodds, Tarra Penney. “…today’s principal neglected public health problem...” (WHO, 1997)

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Maternal weight and the obesogenic environment in nova scotia

Maternal weight and the obesogenic environment in Nova Scotia

Sara Kirk, Louise Parker, Trevor Dummer, Linda Dodds, Tarra Penney


“…today’s principal neglected public health problem...”(WHO, 1997)

“…one of the most important medical and public health problems of our time..."(Prof. Philip James, IOTF Chairman)

“…given the prevalence of childhood obesity, and given its contribution to many diseases, this is the first generation that may not live as long as their parents…”(Dr. Kellie Leitch)

The obesity time bomb




So what happened
So, what happened? province, 2004

www.foresight.gov.uk


Pregnancy and post partum an ideal time for intervention

Obese mothers are at a high risk for many complications province, 2004

Children with obese parents are themselves more likely to be obese as adults

Supportive programming for mothers is key to obesity prevention

Pregnancy and post-partum: an ideal time for intervention


The pregnant population in Canada province, 2004

  • No national surveillance system that routinely measures pregnancy weight in Canada

  • Canadian Perinatal Surveillance system (CPSS) collects 27 health outcomes but not BMI of the mother


The Atlee Perinatal Database province, 2004

  • Provincial level population-based, computerized database with information on pregnancy outcomes

  • Maternal/newborn data available for every pregnancy of > 20 weeks gestation, with a birth weight of 500g or more

  • Data on self-reported pre-pregnancy weights from 1988


To describe the temporal, socio-economic and demographic trends in normal weight and obese pregnant women in Nova Scotia

Part of a larger study investigating the influence of the obesogenic environment on maternal body weight

Objective


Methods trends in normal weight and obese pregnant women in Nova Scotia

  • Self-reported pre-pregnancy weights on women in NS (1988-2006)

    • 172,373 deliveries (2108 multiple births)

    • normal weight = 55-75 kg

    • moderately obese = 90-120 kg

    • severely obese > 120 kg

  • Analyses to look at trends in maternal body weight by:

    • Time

    • Age

    • Parity

    • SES

    • Urban/rural


Subject characteristics trends in normal weight and obese pregnant women in Nova Scotia


Variation in maternal bodyweight over time, 1988-2006 trends in normal weight and obese pregnant women in Nova Scotia

8.6 kg increase

72.0

70.0

mean

68.0

median

66.0

64.0

Bodyweight (kg)

62.0

60.0

58.0

56.0

54.0

52.0

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

Year




Summary of results >120kg

  • Obese women:

    • were slightly older

    • were of lower SES

    • gained less weight during pregnancy

    • were more likely to live in rural areas


Conclusions


  • In-depth exploration of 20 years in Nova Scotiathe influence of the obesogenic environment on maternal body weight

  • Investigation of maternal obesity in the context of the child

  • Recommendations for family-centred management and prevention

What next?


Acknowledgements


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